Nasal obstruction as a drug side effect

Cingi, Cemal; Özdoğanoğlu, Tunis; Songu, Murat

doi:10.1177/1753465811403348

Cited by 18 publications

(13 citation statements)

References 38 publications

(57 reference statements)

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“…A list of these medications, including nonsteroidal anti-inflammatory drugs, antihypertensives, psychotropic drugs, hormones, and immunosuppressants, have been outlined in detail elsewhere. 20 Nasal decongestants including oxymetazoline, xylometazoline, ephedrine, and cocaine have a localized effect on autonomic control and prolonged use can result in rebound rhinitis (rhinitis medicamentosa), although the pathophysiology of this is not entirely understood. In patients with particularly troublesome nasal function, the initial brief benefit of these medications can result in prolonged use and subsequent paradoxical worsened symptoms.…”

Section: Medication Considerationsmentioning

confidence: 99%

“…21 Of note, αadrenergic agonists used for glaucoma can enter the nose through the nasolacrimal canal and also act like topical decongestants with resulting rebound nasal congestion with prolonged use. 20 The process of titrating a patient off nasal decongestants can be challenging. One approach is to dilute the decongestant with nasal saline after each use to decrease each subsequent dose while simultaneously using a nasal steroid.…”

Section: Medication Considerationsmentioning

confidence: 99%

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Functionally Crippled Nose

Patel

Most

2020

Facial plast Surg

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Nasal obstruction is a common presenting symptom of patients seen by primary care physicians, otolaryngologists, and facial plastic surgeons. A variety of treatment strategies, both surgical and nonsurgical, have been used with success in improving nasal obstruction and quality of life. In a subset of patients, many of whom have either attempted these common treatment strategies or are intolerant of them, nasal obstruction remains a significant symptom. In these patients, there may be an identifiable problem, but it is simply not repairable or there is no identifiable anatomic issue. The management of these patients is discussed in this article, with an emphasis on a sensitive approach that takes into consideration a patient's mental health. While the need for diagnostic testing is generally not necessary for most cases of nasal obstruction, endoscopy and imaging should be considered in these patients. Validated patient-reported outcome measures are particularly helpful in providing an objective measure to a patient's frustrating symptoms. A variety of medications can be either contributory to the patient's symptoms or therapeutic if used appropriately. A variety of surgical interventions can also result in a functionally crippled nose and diagnoses including nasal valve stenosis, septal perforations, and empty nose syndrome are discussed. Importantly, further surgical interventions may not be appropriate if a deformity is minimal, and a surgeon should resist the temptation to proceed with surgery in those situations.

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Section: Medication Considerationsmentioning

confidence: 99%

Section: Medication Considerationsmentioning

confidence: 99%

Functionally Crippled Nose

Patel

Most

2020

Facial plast Surg

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“…-Personal history: Data should be gathered on history of atopy, exposure (allergenic, occupational, or irritant), trauma, nasal surgery, recurrent sinusitis, rhinitis/ asthma caused by nonsteroidal anti-inflammatory drugs, obstructive sleep apnea, cystic fibrosis, hypothyroidism, pregnancy, chronic infectious diseases (syphilis, leprosy, tuberculosis), systemic vasculitis (Wegener disease and Churg-Strauss syndrome), and malignant vasculitis [26]. -Drugs and substance abuse: Record the use of intranasal decongestants, regular medication that can influence obstruction (antithyroid drugs, antipsychotics, antihypertensives, oral contraceptives, antidepressants), cocaine, and tobacco [27].…”

Section: Medical Historymentioning

confidence: 99%

“…The questionnaire has been translated into Spanish and validated, its psychometric properties are sufficient, and it is closely correlated with the VAS [35]. It has been estimated that the NOSE questionnaire yields a mean value of 15 (17) in the asymptomatic individual and 42 (27) in the general population [23]. -CQ7.…”

Section: Subjective Evaluation Of Nomentioning

confidence: 99%

Position Paper on Nasal Obstruction: Evaluation and Treatment

Valero

Navarro²,

Cuvillo³

et al. 2018

J Investig Allergol Clin Immunol

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Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care and may affect up to 30%-40% of the population. It affects quality of life (especially sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment. NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors, which may be anatomical, inflammatory, neurological, hormonal, functional, environmental, or pharmacological in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analog scale, symptom score, standardized questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation between the results, they may be considered complementary and not exclusive. Assessing the impact on quality of life through questionnaires standardized according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the etiology is inflammatory or functional. Surgery may be necessary when medical treatment fails to complement or improve medical treatment or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary.

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“…Primary sensory neurons releasing neurotransmittors can also cause increased mucosal swelling and fluid production. Finally, drugs that have a vasoactive effect can increase the thickness of mucosal lining and increase the serous fluid production (Cingi, 2011). Fluid filled sinuses can therefore be an incidental finding, especially in bedridden patients, and must be interpreted with care (Naclerio, 2010;Sarin, 2006).…”

Section: Mucociliary Clearance and Normal Mucosal Variantsmentioning

confidence: 99%

Imaging Rhinosinusitis

Beate¹

2011

Peculiar Aspects of Rhinosinusitis

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Nasal obstruction as a drug side effect

Cited by 18 publications

References 38 publications

Functionally Crippled Nose

Functionally Crippled Nose

Position Paper on Nasal Obstruction: Evaluation and Treatment

Imaging Rhinosinusitis

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